Written by

Gregory Korte

USA TODAY

WASHINGTON — Congress' own health insurance could be one of the last obstacles to reaching a deal to reopen the government and avoid default.

House Republicans floated a bill Tuesday that would have ended the 16-day federal government shutdown and raised the debt limit, but it also would have eliminated the employer contribution for health care for all members of Congress, their staffs, the president, the vice president, and all their political appointees.

Republicans say the employer contribution amounts to a "congressional exemption" from the effects of the 2010 Affordable Care Act.

The truth is that members of Congress are treated differently under Obamacare, but they're not exempt. In fact, by forcing them to purchase health insurance through publicly run exchanges, members of Congress are even more subjected to the law than than similar employees in private sector — or even in government.

However, under the current interpretation of the law by the Office of Personnel Management, members of Congress will also be able to purchase their insurance under terms that are more favorable than other employees — in government or in business — who have access to employer-provided health care.

Here's the history: During the 2010 debate over the Affordable Care Act, Sen. Chuck Grassley, R-Iowa, proposed an amendment requiring members of Congress and their staffs to purchase health insurance though state exchanges. Democrats, viewing the amendment as a political stunt, co-opted the idea as their own and inserted it into the bill.

The provision was silent about who would pay for that insurance, or how those payments would be treated. The exchanges were intended for uninsured people who couldn't get health insurance through their employer or qualify for Medicaid. Those who had access to health benefits meeting minimum coverage levels could still purchase insurance on the exchanges — but without a subsidy and using after-tax income.

Holding members of Congress and their staffs to that standard would have the effect of stripping them of the employer-paid health coverage they currently get, which is the same as any other federal employee. So the Office of Personnel Management issued a proposed rule in August making clear that the government would continue to pay the employer contribution for congressional health benefits at the same rate as if members were still on the federal plan.

(Page 2 of 2)

Grassley now says that was his intent all along. "My goal, regardless of how the amendment was worded … was that we need to go into the exchange so that we would have to go through the same red tape as every other citizen," he told Roll Call last month. But because of what Grassley called a "drafting error," the amendment left out language that would have explicitly given lawmakers the same before-tax employer contribution that any other federal employee gets.

Some of Grassley's Republican colleagues have a different interpretation. Sen. David Vitter, R-La., introduced an unsuccessful amendment to the spending bill that would have required members of Congress to pay the full cost of their health care. That amendment resurfaced as the central point of controversy in the House version to fund the government and extend the debt limit.

"That 'no Washington exemptions' language would be the only thing in that proposal that hasn't been agreed to by Senate Democrats," Vitter said in a speech in the Senate on Tuesday. "So the question will be, is this perceived crisis, this standoff really going to be continued over that? Over their wallets? Over their special elite status?"

"That's it? That;s what this is all about? We have shut down the government, and we have run the risk of defaulting on our debts for the first time in history, over whether or not our employees, the people on our staff, are going to get a federal government contribution toward paying their health insurance? That's pathetic," Durbin said. "I believe employer-sponsored health insurance is a good thing, that we ought to protect."

The issue is an emotional one on Capitol Hill. Sen. Lindsey Graham, R-S.C., said lawmakers can'd discuss it calmly. "If you even bring it up, you'd have thought that you had shot somebody's dog," he said. "People just freak out."

The Vitter Amendment, as its come to be known, would also ensure that the president, vice president and political appointees would not get an employer contribution. And because the Affordable Care Act was vague about which congressional employees would be required to buy insurance on exchanges, the amendment would also include staff members of committees and leadership offices.